MARY STUART
West Des Moines,Iowa
Summary
Offering strong foundation in medical terminology and coding principles, with eagerness to learn and grow in dynamic healthcare environment. Brings ability to quickly understand complex coding systems and guidelines. Ready to use and develop analytical skills and attention to detail in Medical Coding Specialist role.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Account Rep III
Mercy One Iowa Heart
10.2022 - Current
- Follows-up on outstanding patient account balances via phone fax, written request and website
- Audits accounts for resolution
- Reviews and processes insurance denials
- Responds to insurance company and patient inquiries received via mail
- Requests insurance and patient refunds and prepares for mailing
- Refiles claims as necessary
- Responds to Customer service inquiries
- Reviews medical record information via computer
- Updates patient information via computer
- Calls other outside sources for information
- Prepares adjustments for application to accounts
- Reviews insurance payments via computer
- Calls insurance companies to verify eligibility
- Requests letters to insurance companies via computer
- Performs other related work as required
Client Services Coordinator
Iowa Ortho
03.2022 - 10.2022
- Oversees all aspects of work comp business for an assigned group of IO physicians
- Register, verify, update, or modify all new work comp patients while obtaining all necessary patient and billing information
- Coordinate with case managers, referring office, or adjusters to obtain outside records prior to an appointment
- Ensure that records received are complete and documented
- Expeditiously obtain all authorizations for workers' compensation appointments and surgeries
- Investigate and follow-up on all incoming phone calls for workers' compensation patients within 24 hours
- Make all appropriate documentation in the patient chart thorough and accurate
- Document phone calls and appropriate items in the case management system
- Forward medical records when requested to case managers, employers and adjusters
- Maintain knowledge of workers compensation laws and offer education to providers and team members
- Coordinate Special Services Requests
- Work closely with doctors to ensure all reports are handled and completed in a timely manner
- Schedule appointments and procedures pertaining to Work comp for the Iowa Ortho Physicians, including (but not limited to) MRI/CT and outpatient testing
- Provide exceptional customer service to patients, employers and insurance companies calling on accounts
- Exhibit complete professionalism in all duties performed as a coordinator
- Communicate with physicians and staff as necessary, to provide concise information and process completion
- Assist nurse case managers and insurance adjusters in coordinating patient care
- Complete all work log tasking within the required parameters
- Track all scheduled tests and ensure accuracy on any notes in patient accounts
- Assist with scheduling
- Provide assistance to the billing department, as needed, to collect overdue claims payment
- Provides excellent customer service to internal and external customers
- Provides assistance in the best interest of Iowa Ortho and our patients
- All other duties as assigned
Account Rep III
Mercy One Iowa Heart
01.2022 - 03.2022
- Company Overview: Industry: Health Care
- Ability to utilize high level thinking to problem solving to bring complex accounts to resolution
- Provide new and recurring training to billing staff
- Assist staff with questions
- Work includes cross coverage in other areas of department as needed
- Participates in performance improvement projects and activities as needed
- Industry: Health Care
Insurance Verification Rep
Mercy One Iowa Heart
10.2021 - 01.2022
- Company Overview: Industry: Health Care
- Ensure authorizations are completed prior to patient treatment
- Resolve any issues with coverage or eligibility
- Coordinate with clinical to obtain charge information for all patients
- Document all authorizations and dates on appointment
- Industry: Health Care
Device Tech
Mercy One Iowa Heart
05.2021 - 10.2021
- Company Overview: Industry: Health Care
- Patient education after implant and express device checks
- Apply external cardiac rhythm monitoring equipment
- Document symptoms, records monitor strip, & routes reports to the appropriate provider for interpretation
- Special projects from head nurse for patient care
- Take calls and answer questions about device issues
- Set appointments for follow up device checks
- Work within the Paceart program to optimize all patient care
- Industry: Health Care
Patient Access Representative
Mercy One Iowa Heart
08.2019 - 05.2021
- Company Overview: Industry: Health Care
- Coordination of functions such as processing of new patients
- Handling of financial transactions such as cash and credit cards, include daily recon (Cash box)
- Schedule coordination of patients to create appointments such as testing, initial consultations and follow up visits
- Direct and indirect customer relations via in person, phone and email
- Assistance of registration/government paperwork including HIPPA
- Additional tasks of compliance ensuring HIPPA remains current
- As the first line of customer interaction provides high quality decision making to ensure best in class customer experiences
- Analyzed and resolved complex customer service issues and to route them through the proper channels
- Industry: Health Care
Venture Capitalist - Personal Assistant
T& L Computer Systems
08.2018 - 05.2019
- Company Overview: Industry: Information Technology
- Research investment of submitted opportunities to see if they are in alignment with company's portfolio goals
- Analyze research includes (candidate's financial health, 3 year growth model, balance sheet)
- Industry: Information Technology
Customer Service Representative
Farmers Insurance
08.2017 - 08.2018
- Company Overview: Industry: Insurance
- Licensed by the California Department of Insurance (Official license provided upon request)
- Qualified broker agent in Casualty /Qualified broker agent in Property
- Disposition of initial policy application to ensure accuracy and data completeness
- Interaction with business and home processing groups such as underwriting, processing, credit, closing and servicing
- My role was as the primary liaison between customers and company to address various scenarios such as trouble resolution, gap fulfillment and conflict resolution
- Writing policies for home, such as HO-1, basic form through HO-8, older home; for business, such as Professional Liability, Workers Compensation, Product Liability, Farmland, and Business Interruption
- Completing renewal certifications and additions as needed by customer request and/or mandated by regulatory mandates
- Overseeing and managing policy audits and based on the result of the audit to provide payment readjustment which could come in the form of either a rebate or a readjusted payment schedule
- Industry: Insurance
Sales Coordinator
Solar Transport
01.2015 - 07.2017
- Company Overview: Industry: Gas Hauling / Transportation
- Managed the Salesforce database
- Negotiated with customers on rates
- Liaison for current and potential customers with weekly and monthly market rates
- Industry: Gas Hauling / Transportation
Business Analytics
Solar Transport
01.2012 - 01.2015
- Company Overview: Industry: Gas Hauling / Transportation
- Analyzed each department for best practices
- Developed a tactical deployment process to ensure twice-daily awareness of market costs, market conditions for maximum utilization of company assets
- Expanded the area of business analytics by maximizing margins, increasing efficiency and reducing non-revenue driver wages
- Revamped current income and financial statements to activity-based allocation and real-time data
- Negotiated with Fortune 500 clients on rates and services
- Industry: Gas Hauling / Transportation
Safety Supervisor
Solar Transport
06.2004 - 01.2012
- Company Overview: Industry: Gas Hauling / Transportation
- Managed accident investigation process, including database management of accident records
- Analyzed and investigated claims, wrote the first report of injury and managed the claim process to closure
- Processing workers compensation claims, working with the adjuster to best identify and resolve issues
- Managed petroleum spills to local, state and federal compliance levels
- Industry: Gas Hauling / Transportation
Education
High School Diploma -
Trinity Accadamy
Des Moines, IA05-1984
Skills
- Customer engagement
- CRM proficiency
- Customer relationship management
- Document management
- Regulatory compliance
- Task prioritization
- Department collaboration
- Excellent communication
- Attention to detail
- Analytical thinking
Certification
CPC Certification, 09/30/24
Daytimetel
(515) 201-4703
Timeline
Account Rep III
Mercy One Iowa Heart
10.2022 - Current
Client Services Coordinator
Iowa Ortho
03.2022 - 10.2022
Account Rep III
Mercy One Iowa Heart
01.2022 - 03.2022
Insurance Verification Rep
Mercy One Iowa Heart
10.2021 - 01.2022
Device Tech
Mercy One Iowa Heart
05.2021 - 10.2021
Patient Access Representative
Mercy One Iowa Heart
08.2019 - 05.2021
Venture Capitalist - Personal Assistant
T& L Computer Systems
08.2018 - 05.2019
Customer Service Representative
Farmers Insurance
08.2017 - 08.2018
Sales Coordinator
Solar Transport
01.2015 - 07.2017
Business Analytics
Solar Transport
01.2012 - 01.2015
Safety Supervisor
Solar Transport
06.2004 - 01.2012
High School Diploma -
Trinity Accadamy
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